PICC置管病人真实体验质性研究的Meta整合

Meta-integration of qualitative research on real-life experiences of patients with PICC catheterization

目的:探讨经外周静脉穿刺置入中心静脉导管(PICC)病人的真实体验,为改善病人导管留置期间的生活质量提供参考。方法:检索国内外数据库中有关PICC置管病人真实体验的质性研究,检索时限为建库至2023年3月31日,采用Meta整合的方法对研究结果进行整合归纳。结果:共纳入15项研究,提炼63个主题,归纳形成14个类别,整合成4个结果,即对个体身心的影响(发生变态反应、恐惧与焦虑、自我形象受损、产生侥幸心理)、对生活与工作的影响(被迫改变习惯、阻碍与家人的相处、增加经济负担)、维护便利性不足与相关知识的缺乏(距离过远、无法独立完成维护、医疗资源分布不均、擅自进行决策、迷茫与困惑)和置管病人的正性体验(受益感与安全感、对护理人员的认可与期待)。结论:护理人员应重视病人PICC导管留置期间的真实体验,实施针对性措施,提高病人生活质量。

Objective:To discuss the real-life experience of patients with peripherally inserted central catheters(PICC)and to provide a reference for improving patients′quality of life during the catheter indwelling period.Methods:Qualitative studies on the real-life experiences of patients with PICC were retrieved from databases in China and abroad.The search time limit was from establishing the database to March 31,2023.The Meta-integration method was used to integrate and summarize the research results.Results:A total of 15 studies were included and 63 themes were extracted.It was summarized into 14 categories and integrated into 4 results:the impact on the individual′s body and mind(allergy,fear and anxiety,damage to self-image,and fluke mentality),impact on life and work(forced to change habits,obstacles getting along with family members,and increasing financial burden),insufficient maintenance convenience and lack of relevant knowledge(too far distance,inability to complete maintenance independently,uneven distribution of medical resources,unauthorized decision-making,and confusion),positive experience of patients(sense of benefit and security;recognition and expectations of nursing staff).Conclusion:Nursing staff should pay attention to patients′real experiences during the indwelling period of PICC and implement targeted measures to improve patients′quality of life.